Levent KILIÇ,
Ömer KARADAĞ,
Abdulsamet ERDEN,
Alper SARI,
Berkan ARMAĞAN,
Gözde Kübra YARDIMCI,
Esra Fırat ŞENTÜRK,
Umut KALYONCU,
Şaziye Şule Apraş BİLGEN,
Sedat KİRAZ,
Ali İhsan ERTENLİ,
Ali AKDOĞAN
14456
Anti-interleukin-6 tocilizumab therapy in Takayasu's arteritis: a real life experience
Background/aim: Tumour necrosis factor inhibitors and anti-interleukin-6 anti-IL-6 therapies are increasingly being used in Takayasu's arteritis TA patients who are unresponsive to corticosteroids ± conventional immunosuppressive agents.The aim of this study is to assess the efficacy and safety of anti-IL-6 tocilizumab therapy in refractory TA patients in real life.Materials and methods: Fifteen TA patients 86.7% were female who received at least 3 cycles of tocilizumab therapy were retrospectively assessed by clinical, laboratory, and radiological evaluations before and after tocilizumab therapy. Results: The median min-max age of the patients at evaluation was 35 20-58 years and the median disease duration from diagnosis was 24 12-168 months. The median min.-max. duration of follow-up after tocilizumab was 15 3-42 months. There was a significant decrease in erythrocyte sedimentation rate ESR , C-reactive protein CRP , and patient global visual analogue scale VAS scores of patients after tocilizumab therapy. The median min.-max. ESR was 26 5-119 vs. 3 2-49 mm/h, P = 0.02; CRP was 39.8 2.4-149.0 vs. 7.9 0-92.9 mg/L, P = 0.017; and patient global VAS was 50 0-90 vs. 30 0-60 , P = 0.027, respectively. In 8 patients, ESR and CRP levels were in the normal range in the last control. Imaging modality results after tocilizumab were available for 9 patients; 8 patients were radiologically stable and regression was seen in 1 patient. Comparable imaging modality results before and after tocilizumab were available for 5 patients; 4 patients were radiologically stable and regression was seen in 1 patient. Radiological findings were consistent with laboratory responses. Glucocorticoid dosages decreased from a mean dosage of 16.2 9.1 mg/day at baseline to 7.1 3.8 mg/day P = 0.001 at the last follow-up visit. There was no increase in the steroid dosage in any of the patients. All patients tolerated tocilizumab well. Conclusion: Based on retrospective real life data, anti-IL-6 tocilizumab appears to be an effective and tolerable treatment option in refractory TA patients.
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